 

<div class="right">

    <h5 class="title"><b>在线充值</b></h5>

    <form method='post'  id="myform" action="{:U('User/Pay/index')}"> 
        <table width="100%" cellspacing="0" class="table_form">
            <tr>
                <th width="80">余额：</th>        
                <td style="padding:0 0 0 10px"><font style="color:#F00; font-size:22px;font-family:Georgia,Arial; font-weight:700">{$vo['amount']}</font> 元</td>
            </tr>
            <tr>
                <th>充值金额：</th>
                <td><input name="price" type="text" id="price" size="8" value="" class="input-text">&nbsp;元<span id="msgid"></span></td>
            </tr>
            <tr>
                <th>充值方式：</th>
                <td>     <select id="pay_type" name="paytype">
                        <option value="0">请选择</option>
                        <option value="1">银行转帐</option>

                    </select> </td>
            </tr>
            <tr>		
                <th>E-mail：</th>
                <td><input name="email" type="text" id="email" size="30" value="{$vo['email']}"  class="input-text"/></td>
            </tr>
            <tr>
                <th>姓 名：</th>
                <td><input name="username" type="text" id="contactname" size="30" value="{$vo['username']}"  class="input-text"/></td>
            </tr>
            <tr>
                <th>电 话：</th>
                <td><input name="telephone" type="text" id="telephone" size="30"  class="input-text" value="{$vo['telephone']}"/> 格式：010-88888888或13888888888<span id="msgid1" ></span></td>
            </tr>

            <tr>
                <th>备  注：</th>
                <td><textarea name="usernote"  id="usernote" rows="5" cols="50" value=></textarea></td>
            </tr>
            <tr>
                <th>{:L('verify')}：</th>
                <td><input name="verifyCode" class="input-text"  class="inputbox" id="verifyCode"  size="6" value="" maxlength="4" /><img src="{:U('Home/Index/verify')}" onclick="javascript:resetVerifyCode();" class="checkcode" align="absmiddle"  title="{:L('resetVerifyCode')}" id="verifyImage"/></td>
            </tr>
            <tr>
                <td></td>
                <td colspan="2"><label>
                        <input type="submit" name="dosubmit" id="dosubmit" value="确 定" class="button"/>
                    </label></td>
            </tr>
        </table>
    </form>
</div>
